Is Hidden Hearing Loss Real?

Every hearing test you’ve ever taken has come back normal. But you dread noisy spaces. There’s something about the cacophony of sounds that makes it challenging to hear what’s happening. So you can never quite make out the words of the conversation you’re supposed to be following, no matter how closely you pay attention.

In these noisy situations–and even sometimes when it’s quiet–it feels like you have hearing loss. But your hearing specialist has run every screening at their disposal and no anomalies were ever detected.

It turns out, you might have something called “hidden hearing loss.” It’s real, and it may affect up to 10% of people who have a hearing impairment.

What Is “Hidden” Hearing Loss?

Typical sensorineural hearing loss can be difficult enough to detect, especially in the early stages. You might not even realize you have hearing loss–but there are special diagnostics and tests designed to detect just that type of impairment.

Hidden hearing loss seems to defy detection. And there’s a very good reason for that: your ears are behaving perfectly. It’s your synapses (the connection between your ears and your primary hearing nerves) that seem to be misfiring.

These misfires cause your synapses to drop pieces of information, so your brain doesn’t receive a complete picture of the sounds your ear is registering. This tends to manifest as an inability to clearly hear speech, especially in crowded spaces. Scientists are still trying to determine what causes hidden hearing loss, but most research currently points to damage due to intense and loud sounds.

How Do I Know if I Have Hidden Hearing Loss?

Several groups are working on innovative tests to detect hidden hearing loss (one of which involves tracking your eye movement to determine your stress level). But because the problem is with the synapse and not the stereocilia in the ear, detection has traditionally proven difficult. Until more accurate tests are widely available, most hearing specialists will rely on symptom descriptions to detect this particular hearing ailment.

You may have hidden hearing loss if:

You often hear people incorrectly: Maybe it seems as though certain sounds are missing from a sentence. Or you just can’t make out specific phrases. If you’re constantly asking people to repeat themselves, it might be a sign you aren’t hearing them very well.

It’s challenging to focus in noisy situations: Before hidden hearing loss was well understood, it was often diagnosed as an attention problem. New research suggests, however, that it’s the hearing loss that causes the attention issues in the first place–it’s incredibly challenging and draining to pay attention to something you can’t hear!

You prefer conversations that happen in a quiet space: Often, those who experience hidden hearing loss will prefer conversations that happen in a quiet space. With less noise, your synapses receive more relevant information, which makes it easier for you to interpret the sounds of speech.

It doesn’t feel right when you pass a hearing test: It’s one thing to be relieved when you pass a hearing test. It’s another altogether to feel surprised or puzzled. If you are convinced something is wrong with your hearing, it’s possible that your hearing test isn’t telling you the whole story.

That’s not to say that hearing tests are somehow insufficient or a waste of time. In the vast majority of cases, hearing screenings can help identify hearing impairments and define the best treatments. Hidden hearing loss is something of an outlier. But that doesn’t mean it’s not real.

How Is Hidden Hearing Loss Treated?

Because we’re just beginning to truly understand hidden hearing loss, there aren’t many tried and tested treatments currently available. That said, there are many people with hidden hearing loss who might benefit from high-tech hearing aids–especially those hearing aids which have sophisticated voice recognition software and speech amplification capabilities. Get your hearing tested to find out if a hearing aid might help.